Mortality of Oesophageal Atresia in a Low-Income Setting: About 21 Cases

Abstract

Introduction: Oesophageal atresia (OA) is an extreme neonatal neonatal surgical emergency which when present, heavily affects the neonate, in Cameroon and in Sub-Saharan Africa generally. The aim of our study was to describe the epidemiological, diagnostic and therapeutic characteristics of deceased patients with oesophageal atresia in our context. Methodology: We conducted an observational, descriptive, retrospective study over a period of 14 years, from the 1st January 2005 to the 28th February 2019. All paediatric patients who died from oesophageal atresia were included. Survivors were excluded (n = 3). Results: Mortality from oesophageal atresia was 87.5% in our series. The average age at the time of presentation was 5.2 days. The notion of attempted feeding at birth was found in 72.2% (n = 13). No antenatal diagnosis was noted. The lung condition was preoccupying in 61% of cases (n = 11). The average operating time was 7 days. Death before any surgical procedure concerned 22.2% of newborns (n = 4). Posterolateral thoracotomy with fistulectomy and oeso-oesophageal anastomosis represented 22.2% of our series (n = 4) while a feeding gastro jejunostomy was done in 66.6% of cases. Two deceased patients had undergone a feeding gastro-jejunostomy followed by a posterolateral thoracotomy. Conclusion: Knowledge of these epidemiological, diagnostic and therapeutic characteristics is a prerequisite for considering an inversion of the mortality curve for oesophageal atresia in our context.